Surgical instruments and methods of assembling surgical instruments
A surgical instrument including a housing, an actuator operably associated with the housing, a shaft extending from the housing, an end effector assembly disposed at an end portion of the shaft, and a drive assembly operably coupling the actuator and the end effector assembly with one another such that actuation of the actuator manipulates the end effector assembly. The drive assembly includes a proximal sleeve defining a longitudinal axis and an interior lumen extending longitudinally therethrough, a drive bar including a proximal portion and a distal portion, and a lock washer configured to engage the proximal portion of the drive bar with the proximal sleeve such that the proximal portion of the drive bar is disposed within the interior lumen of the proximal sleeve and positioned offset relative to the longitudinal axis of the proximal sleeve. Methods of assembling such drive assemblies are also provided.
The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 62/551,459, filed on Aug. 29, 2017 the entire contents of which are incorporated herein by reference.
BACKGROUND Technical FieldThe present disclosure relates to surgical instruments and methods of assembling the same.
Background of Related ArtBipolar surgical instruments typically include two generally opposing electrodes charged to different electric potentials to selectively apply energy to tissue. Bipolar electrosurgical forceps, for example, utilize both mechanical clamping action and electrical energy to treat, e.g., cauterize, coagulate, desiccate, and/or seal, tissue. Once tissue is treated, it is often desirable to cut the treated tissue. Accordingly, many forceps have been designed which incorporate a knife that effectively severs the tissue after tissue treatment.
Monopolar surgical instruments, on the other hand, include an active electrode, and are used in conjunction with a remote return electrode, e.g., a return pad, to apply energy to tissue. Monopolar instruments have the ability to rapidly move through tissue and dissect through narrow tissue planes.
In some surgical procedures, it may be beneficial to use both bipolar and monopolar instrumentation, e.g., procedures where it is necessary to dissect through one or more layers of tissue in order to reach underlying tissue(s) to be treated. Further, it may be beneficial, particularly with respect to endoscopic surgical procedures, to provide a single instrument incorporating both bipolar and monopolar features, thereby obviating the need to alternatingly remove and insert the bipolar and monopolar instruments in favor of one another.
As can be appreciated, as additional functional components and/or features are added to a surgical instrument, arranging the components of the surgical instrument and/or assembly of the surgical instrument becomes increasingly complex due to, for example, spatial constraints and/or functional constraints of the components.
SUMMARYAs used herein, the term “distal” refers to the portion that is being described that is further from a user, while the term “proximal” refers to the portion that is being described that is closer to a user. Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any of the other aspects described herein.
Provided in accordance with aspects of the present disclosure is a surgical instrument including a housing, an actuator operably associated with the housing, a shaft extending distally from the housing, an end effector assembly disposed at a distal end portion of the shaft, and a drive assembly extending through the housing and the shaft and operably coupling the actuator and the end effector assembly with one another such that actuation of the actuator manipulates the end effector assembly. The drive assembly includes a proximal sleeve defining a longitudinal axis and an interior lumen extending longitudinally therethrough, a drive bar including a proximal portion and a distal portion, and a lock washer configured to engage the proximal portion of the drive bar with the proximal sleeve such that the proximal portion of the drive bar is disposed within the interior lumen of the proximal sleeve and positioned offset relative to the longitudinal axis of the proximal sleeve.
In an aspect of the present disclosure, the drive assembly further includes a mandrel assembly disposed about the proximal sleeve. The mandrel assembly operably couples the actuator and the proximal sleeve with one another.
In another aspect of the present disclosure, the actuator includes a movable handle operably coupled to the mandrel assembly. The movable handle is movable relative to the housing from an initial position to a compressed position to move the drive assembly through the housing and the shaft to manipulate the end effector assembly.
In yet another aspect of the present disclosure, the end effector assembly includes first and second jaw members, the first and/or second jaw members movable relative to the other between a spaced-apart position and an approximated position.
In another aspect of the present disclosure, the movable handle is movable relative to the housing from an initial position to a compressed position to manipulate the end effector assembly, e.g., to move the first and/or second jaw members relative to the other between the spaced-apart position and the approximated position.
In still another aspect of the present disclosure, the proximal sleeve defines a keyed slot including a longitudinally-extending portion and a transverse portion. In such aspects, the lock washer may include a finger configured for engagement within the transverse portion of the keyed slot of the proximal sleeve. Further, the lock washer may define seats on either side of the finger configured to receive edges of the proximal sleeve that define ends of the transverse portion of the keyed slot.
In yet another aspect of the present disclosure, the lock washer defines a U-shaped aperture configured to receive the proximal sleeve therethrough.
In still yet another aspect of the present disclosure, the lock washer includes a finger extending into the interior lumen of the proximal sleeve and defining a slot configured to engage the proximal portion of the drive bar with the lock washer. In such aspects, the proximal portion of the drive bar may define a notch configured for receipt within the slot of the finger of the lock washer. More specifically, the slot of the finger may include a circular portion and a vertical portion. The proximal portion of the drive bar is insertable proximally through the circular portion and movable transversely from the circular portion into the vertical portion.
In another aspect of the present disclosure, the circular portion of the slot of the finger is offset relative to the vertical portion of the slot of the finger in a direction and the notch of the drive bar is oriented to face the direction of the offset.
In another aspect of the present disclosure, when the drive bar is disposed within the circular portion of the slot of the finger, the drive bar is outside the proximal sleeve and wherein, when the drive bar is moved to the vertical portion of the slot of the finger, the drive bar is disposed within the interior lumen of the proximal sleeve.
A method of assembling a drive assembly of a surgical instrument provided in accordance with aspects of the present disclosure includes sliding a lock washer proximally along a proximal sleeve, moving the lock washer transversely relative to the proximal sleeve such that a finger of the lock washer is engaged within a transverse slot defined within the proximal sleeve, inserting a drive bar proximally through a slot defined within the lock washer with the drive bar disposed exteriorly of the proximal sleeve, and moving the drive bar transversely through the slot of the lock washer such that the drive bar passes through a longitudinal slot defined within the proximal sleeve and into an interior lumen of the proximal sleeve to a position offset relative to a longitudinal axis defined by the proximal sleeve.
Various aspects of the present disclosure are described herein with reference to the drawings wherein like reference numerals identify similar or identical elements and:
Referring generally to
Continuing with reference to
Instrument 10 may also include an electrosurgical cable (not shown) that connects instrument 10 to a generator (not shown) or other suitable power source, although instrument 10 may alternatively be configured as a battery-powered instrument. The electrosurgical cable (not shown) includes wires (not shown) extending therethrough that have sufficient length to extend through housing 20 and/or elongated shaft assembly 80 in order to provide energy to at least one of the electrically-conductive surfaces 112, 122 of jaw members 110, 120, respectively, of end effector assembly 100, e.g., upon activation of bipolar activation switch 172 of bipolar activation assembly 170 in the bipolar mode of operation. Similarly, one or more of the wires of the electrosurgical cable (not shown) extends through housing 20 and/or elongated shaft assembly 80 in order to provide energy to monopolar assembly 200, e.g., upon activation of either of the monopolar activation switches 182 of monopolar activation assembly 180 in the monopolar mode of operation.
Elongated shaft assembly 80 includes a fixed outer tube 82 having a proximal ferrule configured for engagement with housing 20 so as to engage fixed outer tube 82 therewith. Fixed outer tube 82 is a semi-rigid component in that it may be resiliently bent up to 35 degrees from a longitudinal axis thereof without permanent deformation or breaking. Fixed outer tube 82 does not extend distally to end effector assembly 100 but, rather, is spaced-apart therefrom, leaving an exposed section of monopolar assembly 200, although it is contemplated that, in some embodiments, fixed outer tube 82 extends to end effector assembly 100. Elongated shaft assembly 80 further includes a shaft having an inner proximal tube 83, an inner distal tube 84, and an inner tube guide 86 formed from a plurality of tube guide segments 87. Inner proximal tube 83 engages rotation assembly 70, as detailed below, and is disposed about a proximal portion of inner tube guide 86. Inner distal tube 84 engages jaw member 120 at the distal end thereof and is disposed about a distal portion of inner tube guide 86. The components of the shaft, e.g., inner proximal tube 83, inner distal tube 84, and inner tube guide 86, are engaged to one another in any suitable manner, e.g., welding, mechanical fastening, gluing, etc., to form the shaft of elongated shaft assembly 80 and such that rotation of inner proximal tube 83 effects corresponding rotation of inner distal tube 84 and inner tube guide 86. As a result, as will become apparent below, rotation of inner proximal tube 83 via rotation of rotation assembly 70 effects corresponding rotation of end effector assembly 100, drive assembly 140, knife assembly 160, and monopolar assembly 200 relative to housing 20 (
As detailed below, elongated shaft assembly 80 is configured to contain and/or support at least a portion of drive bar 148 of drive assembly 140, knife bar 162 of knife assembly 160, and energizable member 220 of monopolar assembly 200 in a non-concentric, non-coaxial arrangement, e.g., wherein drive bar 148, knife bar 162, and energizable member 220 extend alongside one another. Insulative sleeve 210 of monopolar assembly 200 is disposed about drive bar 148, knife bar 162, and energizable member 220 and is likewise non-concentrically and non-coaxially arranged about these components. Insulative sleeve 210 may be semi-rigid, similarly as detailed above, to enable bending. Further, drive bar 148, knife bar 162, and energizable member 220 are at least as flexible as the components of elongated shaft assembly 80, and define diameters significantly smaller than that diameters of the tubes 82, 83, 84, 86 of elongated shaft assembly 80 as well as insulative sleeve 210. For example, the diameters of drive bar 148, knife bar 162, and energizable member 220 may each be between one-third and one-tenth of the diameters of each or any of tubes 82, 83, 84, 86 and insulative sleeve 210. Such a configuration allows for deployment and/or actuation of end effector assembly 100 and monopolar assembly 200 even where elongated shaft assembly 80 (and the components extending therethrough) is resiliently bent up to 35 degrees from the longitudinal axis thereof.
With reference to
End effector assembly 100 is designed as a unilateral assembly, e.g., where jaw member 120 is fixed relative to elongated shaft assembly 80, e.g., jaw member 120 is engaged with inner distal tube 84 of elongated shaft assembly 80, and jaw member 110 is movable relative to elongated shaft assembly 80 and fixed jaw member 120. However, end effector assembly 100 may alternatively be configured as a bilateral assembly, i.e., where both jaw member 110 and jaw member 120 are movable relative to one another and to elongated shaft assembly 80. Further, in some embodiments, a longitudinally-extending knife channel 126 (
Referring to
With reference to
Referring to
Drive bar 148 defines a notch 151 therein towards the proximal end thereof that is configured, in conjunction with a drive bar support member 153 and return washer 155, to facilitate operable coupling of drive bar 148 with proximal sleeve 141. Drive assembly 140 further includes a support tube 158 disposed about drive bar 148. Support tube 158 extends about drive bar 148 but defines a shorter length than drive bar 148 such that the distal end of support tube 158 is position proximally of arm 149 and such that the proximal end of support tube 158 is positioned distally of notch 151. Support tube 158 defines a proximal slot 159a and a distal slot 159b. Support tube 158 and drive bar 148 are configured for receipt within a channel defined within inner guide tube 86 of elongated shaft assembly 80 (see
With reference to
Referring to
With reference to
Turning to
With return washer 155 in position as detailed above, drive bar 148 and drive bar support member 153 are advanced proximally into proximal sleeve 141 and towards return washer 155 such that cantilever spring arm 157a is flexed outwardly. Drive bar 148 and drive bar support member 153 are moved further proximally until elongated protrusion 154d of drive bar support member 153 abuts locking finger 156b of return washer 155. At this point, cantilever spring arm 157a remains outwardly-flexed.
Next, return washer 155 is rotated relative to proximal sleeve 141, drive bar 148, and drive bar support member 153 such that locking finger 156b moves through semi-annular slot 157c of proximal sleeve 141. Return washer 155 is rotated, as indicated by arrow “R” (
Once return washer 155 has been rotated as detailed above, locking finger 156b no longer abuts drive bar support member 153. Drive bar support member 153 may then be moved proximally relative to proximal sleeve 141 until elongated slot 157b defined within cantilever spring arm 157a is aligned with elongated protrusion 154d, thus allowing cantilever spring arm 157a to return inwardly under bias so as to capture elongated protrusion 154d within elongated slot 157b to engage drive bar support member 153 with proximal sleeve 141. Further, with drive bar support member 153 and proximal sleeve 141 engaged in this manner, return washer 155 is inhibited from rotating back in the opposite direction of arrow “R” (
Referring to
Referring to
With additional reference to
Knife assembly 160 includes knife bar 162, knife 164, and a knife collar 166. Knife collar 166 is coaxial with mandrel assembly 142 and proximal sleeve 141 of drive assembly 140 (see
Knife collar 166 is slidably disposed about proximal sleeve 141 of drive assembly 140. Proximal foot 163a of knife bar 162 extends through elongated cut-out 163b of proximal sleeve, as mentioned above, and is received within an annular slot 167 defined within knife collar 166 to rotatably engage knife collar 166 about the proximal end of knife bar 162 with proximal sleeve 141 of drive assembly 140 disposed therebetween. Knife collar 166 further defines a transverse aperture 168 configured to receive transverse pin 68 of trigger assembly 60 to operably couple trigger assembly 60 and knife assembly 160 with one another.
Upon actuation of trigger 62 from the un-actuated position to the actuated position, toggle portion 65 of trigger is pivoted about split pivot 64 in a generally proximal direction while bifurcated portion 66 is pivoted about split pivot 64 in a generally distal direction. Such distal movement of bifurcated portion 66 of trigger 62 urges transverse pin 68 distally, thereby urging knife collar 166 distally. Distal urging of knife collar 166 urges proximal foot 163a of knife bar 162 to translate through elongated cut-out 163b of proximal sleeve 141, thereby translating knife bar 162 and knife 164 distally relative to drive assembly 140, elongated shaft assembly 80, and end effector assembly 100 from the retracted position to the extended position to cut tissue grasped between jaw members 110, 120. In some embodiments, a biasing member (not shown) configured to bias trigger 62 towards the un-actuated position and, thus, knife 164 towards the retracted position, may be provided.
Turning to
Rotation assembly 70 further includes an engagement ferrule 74, an engagement clip 76, and a retainer 78 that, as detailed below, cooperate to enable engagement of rotation wheel 72 and fixed outer tube 82 without the need for precision joining, such as welding, while ensuring accurate placement of rotation wheel 72 on inner proximal tube 83 of elongated shaft assembly 80. This positioning is important to ensure proper spacing of rotation wheel 72 relative to end effector assembly 100 such that the proper positionings, clearances, and/or ranges of motions of the various components extending through elongated shaft assembly 80 to end effector assembly 100 are achieved.
Rotation wheel 72, as shown in
Engagement ferrule 74, as shown in
Engagement clip 76, as shown in
Retainer 78, as shown in
Referring to
Referring to
With reference to
Turning to
Assembly using G-clip 476 is initially similar to that detailed above. That is, engagement ferrule 74 is first engaged with rotation wheel 72, and then inner proximal tube 83 of elongated shaft assembly 80 is inserted into engagement ferrule 74 such that window 88 defined through inner proximal tube 83 is aligned with window 75f defined within engagement ferrule 74. Once this position has been achieved, G-clip 476 is inserted about engagement ferrule 74 transversely. That is, G-clip 476 is urged transversely about engagement ferrule 74 such that engagement ferrule 74 urges cantilever arms 477b, 477c outwardly relative to one another to widen gap 477d and permit insertion of engagement ferrule 74 therethrough. G-clip 476 is moved further transversely relative to engagement ferrule 74 such that middle finger 477h of hand 477f extends through windows 75f, 88, thereby engaging inner proximal tube 83 and engagement ferrule 74 with one another. Upon reaching this position, the inward bias of arms 477b, 477c into contact with engagement ferrule 74 retains G-clip 476 about engagement ferrule 74, while outer fingers 477g and 477i are biased inwardly into engagement within annular recess 75e of engagement ferrule 74 to retain middle finger 477h in engagement with windows 75f, 88. This completes the assembly of rotation wheel 72 to inner proximal tube 83 using G-clip 476.
With reference to
Energizable member 220 of monopolar assembly 200 includes a proximal cap 222, a bar 224, and an energizable element 226. Proximal cap 222 is engaged to bar 224 at the proximal end thereof and is operably engaged with deployment and retraction mechanism 300 for selectively deploying and retracting monopolar assembly 200. Bar 224 extends from proximal cap 222 distally through housing 20. Energizable element 226 extends through proximal bar 224 and distally therefrom to a distal tissue-treating portion 227. Energizable element 226 is coupled to the source of energy (not shown) and monopolar activation assembly 180 (
Referring to
Referring also to
Turning to
With reference to
Referring to
Lock washer 1155 is configured to engage drive bar 1148 with proximal sleeve 1141 at a distal end portion 1142b of proximal sleeve 1141. More specifically, lock washer 1155 is configured to engage drive bar 1148 with proximal sleeve 1141 such that drive bar 1148 extends in parallel orientation but offset relative to a longitudinal axis defined through proximal sleeve 1141. In embodiments, as detailed above with respect to drive assembly 140 (see
With additional reference to
Lock washer 1155 additionally includes a finger 1156f extending inwardly into U-shaped aperture 1156d. First and second seats 1156g are defined between finger 1156f and the first and second half-moon wedges 1156e on opposite sides of U-shaped aperture 1156d. Finger 1156f further defines a slot 1156h having a vertical portion 1156i, a throat 1156j, and a circular portion 1156k. Throat 1156j is disposed at an end of vertical portion 1156i and is disposed between and in communication with vertical portion 1156i of slot 1156h and U-shaped aperture 1156d. Circular portion 1156k is disposed at an opposite end of vertical portion 1156i in communication therewith. Circular portion 1156k is offset relative to vertical portion 1156i. That is, a center of circular portion 1156k is laterally offset from a vertical axis of vertical portion 1156i.
Referring again to
Drive bar 1148, similarly as detailed above with respect to drive bar 148 of drive assembly 140 (
Turning to
Referring to
With additional reference to
Referring to
The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon in the operating room and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
From the foregoing and with reference to the various drawing figures, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Claims
1. A surgical instrument, comprising:
- a housing;
- an actuator operably associated with the housing;
- a shaft extending distally from the housing;
- an end effector assembly disposed at a distal end portion of the shaft; and
- a drive assembly extending through the housing and the shaft, the drive assembly operably coupling the actuator and the end effector assembly with one another such that actuation of the actuator manipulates the end effector assembly, the drive assembly including: a proximal sleeve defining a longitudinal axis and an interior lumen extending longitudinally therethrough; a drive bar including a proximal portion and a distal portion; and a lock washer configured to engage the proximal portion of the drive bar with the proximal sleeve such that the proximal portion of the drive bar is disposed within the interior lumen of the proximal sleeve and positioned offset relative to the longitudinal axis of the proximal sleeve, wherein the lock washer includes a finger extending into the interior lumen of the proximal sleeve, the finger defining a slot configured to engage the proximal portion of the drive bar with the lock washer, and wherein the proximal portion of the drive bar defines a notch configured for receipt within the slot of the finger of the lock washer, and wherein the slot of the finger includes a circular portion and a vertical portion, wherein the proximal portion of the drive bar is insertable proximally through the circular portion and movable transversely from the circular portion into the vertical portion.
2. The surgical instrument according to claim 1, wherein the drive assembly further includes a mandrel assembly disposed about the proximal sleeve, the mandrel assembly operably coupling the actuator and the proximal sleeve with one another.
3. The surgical instrument according to claim 2, wherein the actuator includes a movable handle operably coupled to the mandrel assembly, the movable handle movable relative to the housing from an initial position to a compressed position to move the drive assembly through the housing and the shaft to manipulate the end effector assembly.
4. The surgical instrument according to claim 1, wherein the end effector assembly includes first and second jaw members, at least one of the first or second jaw members movable relative to the other between a spaced-apart position and an approximated position.
5. The surgical instrument according to claim 1, wherein the actuator includes a movable handle operably coupled to the housing, the movable handle movable relative to the housing from an initial position to a compressed position to manipulate the end effector assembly.
6. The surgical instrument according to claim 5, wherein the end effector assembly includes first and second jaw members, at least one of the first or second jaw members movable relative to the other from a spaced-apart position to an approximated position in response to movement of the movable handle from the initial position to the compressed position.
7. The surgical instrument according to claim 1, wherein the proximal sleeve defines a keyed slot including a longitudinally-extending portion and a transverse portion.
8. The surgical instrument according to claim 7, wherein the finger of the lock washer is configured for engagement within the transverse portion of the keyed slot of the proximal sleeve.
9. The surgical instrument according to claim 8, wherein the lock washer defines seats on either side of the finger, the seats configured to receive edges of the proximal sleeve that define ends of the transverse portion of the keyed slot.
10. The surgical instrument according to claim 1, wherein the lock washer defines a U-shaped aperture configured to receive the proximal sleeve therethrough.
11. The surgical instrument according to claim 1, wherein the circular portion is offset relative to the vertical portion in a direction, and wherein the notch of the proximal portion of the drive bar is oriented to face the direction of the offset.
12. The surgical instrument according to claim 1, wherein, when the proximal portion of the drive bar is disposed within the circular portion, the proximal portion of the drive bar is outside the proximal sleeve and wherein, when the proximal portion of the drive bar is moved to the vertical portion of the slot, the proximal portion of the drive bar is disposed within the interior lumen of the proximal sleeve.
13. The surgical instrument according to claim 1, wherein the surgical instrument is adapted to connect to an electrosurgical generator.
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- Extended European Search Report issued in European Application No. 18191069.6 dated Jan. 4, 2019, 8 pages.
Type: Grant
Filed: Jul 3, 2018
Date of Patent: Oct 26, 2021
Patent Publication Number: 20190059989
Inventor: Zachary S. Heiliger (Nederland, CO)
Primary Examiner: Thomas A Giuliani
Application Number: 16/026,437
International Classification: A61B 18/14 (20060101); A61B 18/12 (20060101); A61B 17/29 (20060101); A61B 34/30 (20160101); A61B 18/00 (20060101);